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General NPI Number Information
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NPI Number | 1245721877
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Entity Type | Individual
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Provider Name | JESSICA COPELAND DPT
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Gender | Female
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Dates
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Enumeration Date | 05/18/2018
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Last Update Date | 09/18/2023
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Provider Practice Location Address
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Address Line | 1404 TUSCULUM BLVD STE 3200
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City | GREENEVILLE
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State | TN
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Zip | 37745-4649
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Country | US
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Telephone | 423-636-2651
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Fax | 423-638-5160
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Provider Business Mailing Address
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Address Line | 1275 DICK LONAS RD UNIT 101
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City | KNOXVILLE
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State | TN
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Zip | 37909-1383
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Country | US
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Telephone | 865-584-4747
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Fax | 865-381-1509
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 11217
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License Number State | TN
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